Are bacteria becoming too smart for antibiotics?

WASHINGTON — They are some of the most common medications in the world, but the day may be coming when bacteria will outsmart most current antibiotics.

The problem? Far too much of a good thing.

An analysis of international data, published earlier this month in the journal Lancet Infectious Diseases, shows an alarming 36 percent surge in worldwide use of antibiotics between 2000 and 2010, much of it unwarranted.

“The more that antibiotics are used, in general, the more risk there is that we will see more resistance to those antibiotics,” says Dr. Jesse Goodman, a physician and professor at the Georgetown University School of Medicine, who formerly served as the Food and Drug Administration’s chief scientist.

What happens is that bacteria, like most living things, respond to pressure in their environment. When confronted over and over again with the same antibiotic, some will mutate in order to survive, creating “superbugs.”

So while it’s good that more people have access to these drugs, Goodman says great care needs to be taken to make sure they’re only given to patients whose conditions warrant them.

That’s especially true for strong medications that are usually considered a treatment of last resort.

“We are moving toward a situation where we have fewer and fewer antibiotics to treat some of the more challenging infections,” says Goodman, who is considered an expert on infectious diseases.

The World Health Organization is working to raise international attention to this threat to public health, warning that a “post-antibiotic era” could be coming. At the same time, a White House task force is wrapping up work on a plan of action to address the problem.

Goodman says all interested parties need to get on board, including doctors, patients and farmers, who increasingly give antibiotics to livestock.

“I think it is a big, big cultural change that needs to happen,” he says.

“They all need to sort of totally think differently about antibiotics.”

He says the message is starting to get through in the United States, where antibiotic use — while still high — has declined in recent years.

However, five countries alone — China, Russia, India, Brazil and South Africa — accounted for more than three-fourths of the rise in antibiotic use in the last decade.

In some parts of the world, Goodman says, antibiotics are available over the counter to anyone who goes into a pharmacy, and often they are taken for conditions where they won’t help at all.

He says an all-out awareness campaign is needed to make sure antibiotics are taken properly.

Goodman also says it’s necessary to provide incentives for the development of new antibiotics.

He expects some great ideas will come out of the White House task force on antibiotic use, but adds the real trick will be finding the money to turn those recommendations into reality.